NAVAROS v. COMMISSIONER OF SOCIAL SECURITY

Filing 34

OPINION and ORDER filed. Signed by Magistrate Judge Norah McCann King (OHSD) on 7/19/2021. (km)

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UNITED STATES DISTRICT COURT
DISTRICT OF NEW JERSEY
VILMA N.,
Plaintiff,

Case No. 2:19-cv-13904
Magistrate Judge Norah McCann King

v.
KILOLO KIJAKAZI,
Acting Commissioner of Social Security,
Defendant.

OPINION AND ORDER
This matter comes before the Court pursuant to Section 205(g) of the Social Security Act,
as amended, 42 U.S.C. § 405(g), regarding the applications of Plaintiff Vilma N. for Disability
Insurance Benefits under Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq., and for
Supplemental Security Income under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381 et
seq. Plaintiff appeals from the final decision of the Commissioner of Social Security denying
those applications. 1 After careful consideration of the entire record, including the entire
administrative record, the Court decides this matter pursuant to Rule 78(b) of the Federal Rules
of Civil Procedure and Local Civil Rule 9.1(f). For the reasons that follow, the Court reverses the
Commissioner’s decision and remands the action for further proceedings.
I.

PROCEDURAL HISTORY
On May 20, 2015, Plaintiff filed applications for disability insurance benefits and

supplemental security income, alleging that she has been disabled since February 26, 2014. R.

Kilolo Kijakazi, the Acting Commissioner of Social Security, is substituted as Defendant in her
official capacity.
1

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239–47. Plaintiff’s applications were denied initially and upon reconsideration. R. 147–52, 154–
59. Plaintiff sought a de novo hearing before an administrative law judge. R. 160. Administrative
Law Judge Peter R. Lee (“ALJ”) held a hearing on February 22, 2018, at which Plaintiff, who
was represented by counsel, testified, as did a vocational expert. R. 39–71. In a decision dated
May 29, 2018, the ALJ concluded that Plaintiff was not disabled within the meaning of the
Social Security Act from February 26, 2014, Plaintiff’s alleged disability onset date, through the
date of the decision. R. 22–31. That decision became the final decision of the Commissioner of
Social Security when the Appeals Council declined review on April 17, 2019. R. 1–8. Plaintiff
timely filed this appeal pursuant to 42 U.S.C. § 405(g). ECF No. 1. On October 16, 2019,
Plaintiff consented to disposition of the matter by a United States Magistrate Judge pursuant to
28 U.S.C. § 636(c) and Rule 73 of the Federal Rules of Civil Procedure. ECF No. 10. 2 On June
10, 2020, the case was reassigned to the undersigned. ECF No. 30. The matter is now ripe for
disposition.
II.

LEGAL STANDARD
A.

Standard of Review

In reviewing applications for Social Security disability benefits, this Court has the
authority to conduct a plenary review of legal issues decided by the ALJ. Knepp v. Apfel, 204
F.3d 78, 83 (3d Cir. 2000). In contrast, the Court reviews the ALJ’s factual findings to
determine if they are supported by substantial evidence. Sykes v. Apfel, 228 F.3d 259, 262 (3d
Cir. 2000); see also 42 U.S.C. §§ 405(g), 1383(c)(3). Substantial evidence “does not mean a
large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind
2

The Commissioner has provided general consent to Magistrate Judge jurisdiction in cases
seeking review of the Commissioner’s decision. See Standing Order In re: Social Security Pilot
Project (D.N.J. Apr. 2, 2018).
2

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might accept as adequate to support a conclusion.” Pierce v. Underwood, 487 U.S. 552, 565
(1988) (citation and internal quotations omitted); see K.K. ex rel. K.S. v. Comm’r of Soc. Sec.,
No. 17-2309 , 2018 WL 1509091, at *4 (D.N.J. Mar. 27, 2018). Substantial evidence is “less
than a preponderance of the evidence, but ‘more than a mere scintilla.”’ Bailey v. Comm’r of Soc.
Sec., 354 F. App’x 613, 616 (3d Cir. 2009) (citations and quotations omitted); see K.K., 2018
WL 1509091, at *4.
The substantial evidence standard is a deferential standard, and the ALJ’s decision cannot
be set aside merely because the Court “acting de novo might have reached a different
conclusion.” Hunter Douglas, Inc. v. NLRB, 804 F.2d 808, 812 (3d Cir. 1986); see, e.g., Fargnoli
v. Massanari, 247 F.3d 34, 38 (3d Cir. 2001) (“Where the ALJ’s findings of fact are supported
by substantial evidence, we are bound by those findings, even if we would have decided the
factual inquiry differently.”) (citing Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999)); K.K.,
2018 WL 1509091, at *4 (“‘[T]he district court ... is [not] empowered to weigh the evidence or
substitute its conclusions for those of the fact-finder.’”) (quoting Williams v. Sullivan, 970 F.2d
1178, 1182 (3d Cir. 1992)).
Nevertheless, the Third Circuit cautions that this standard of review is not “a talismanic
or self-executing formula for adjudication.” Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir. 1983)
(“The search for substantial evidence is thus a qualitative exercise without which our review of
social security disability cases ceases to be merely deferential and becomes instead a sham.”);
see Coleman v. Comm’r of Soc. Sec., No. 15-6484, 2016 WL 4212102, at *3 (D.N.J. Aug. 9,
2016). The Court has a duty to “review the evidence in its totality” and “take into account
whatever in the record fairly detracts from its weight.” K.K., 2018 WL 1509091, at *4 (quoting
Schonewolf v. Callahan, 972 F. Supp. 277, 284 (D.N.J. 1997) (citations and quotations omitted));
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see Cotter v. Harris, 642 F.2d 700, 706 (3d Cir. 1981) (stating that substantial evidence exists
only “in relationship to all the other evidence in the record”). Evidence is not substantial if “it is
overwhelmed by other evidence,” “really constitutes not evidence but mere conclusion,” or
“ignores, or fails to resolve, a conflict created by countervailing evidence.” Wallace v. Sec’y of
Health & Human Servs., 722 F.2d 1150, 1153 (3d Cir. 1983) (citing Kent, 710 F.2d at 114); see
K.K., 2018 WL 1509091, at *4. The ALJ decision thus must be set aside if it “did not take into
account the entire record or failed to resolve an evidentiary conflict.” Schonewolf, 972 F. Supp.
at 284-85 (citing Gober v. Matthews, 574 F.2d 772, 776 (3d Cir. 1978)).
Although an ALJ is not required “to use particular language or adhere to a particular
format in conducting [the] analysis,” the decision must contain “sufficient development of the
record and explanation of findings to permit meaningful review.” Jones v. Barnhart, 364 F.3d
501, 505 (3d Cir. 2004) (citing Burnett v. Comm’r of Soc. Sec., 220 F.3d 112, 119 (3d Cir.
2000)); see K.K., 2018 WL 1509091, at *4. The Court “need[s] from the ALJ not only an
expression of the evidence s/he considered which supports the result, but also some indication of
the evidence which was rejected.” Cotter, 642 F.2d at 705-06; see Burnett, 220 F.3d at 121
(“Although the ALJ may weigh the credibility of the evidence, [s/]he must give some indication
of the evidence which [s/]he rejects and [the] reason(s) for discounting such evidence.”) (citing
Plummer v. Apfel, 186 F.3d 422, 429 (3d. Cir. 1999)). “[T]he ALJ is not required to supply a
comprehensive explanation for the rejection of evidence; in most cases, a sentence or short
paragraph would probably suffice.” Cotter, 650 F.2d at 482. Absent such articulation, the Court
“cannot tell if significant probative evidence was not credited or simply ignored.” Id. at 705. As
the Third Circuit explains:
Unless the [ALJ] has analyzed all evidence and has sufficiently explained the
weight [s/]he has given to obviously probative exhibits, to say that [the] decision is
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supported by substantial evidence approaches an abdication of the court’s duty to
scrutinize the record as a whole to determine whether the conclusions reached are
rational.
Gober, 574 F.2d at 776; see Schonewolf, 972 F. Supp. at 284-85.
Following review of the entire record on appeal from a denial of benefits, the Court can
enter “a judgment affirming, modifying, or reversing the decision of the [Commissioner], with or
without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). Remand is appropriate if the
record is incomplete or if the ALJ’s decision lacks adequate reasoning or contains illogical or
contradictory findings. See Burnett, 220 F.3d at 119-20; Podedworny v. Harris, 745 F.2d 210,
221-22 (3d Cir. 1984). Remand is also appropriate if the ALJ’s findings are not the product of a
complete review which “explicitly weigh[s] all relevant, probative and available evidence” in the
record. Adorno v. Shalala, 40 F.3d 43, 48 (3d Cir. 1994) (internal quotation marks omitted); see
A.B. on Behalf of Y.F. v. Colvin, 166 F. Supp.3d 512, 518 (D.N.J. 2016). A decision to “award
benefits should be made only when the administrative record of the case has been fully
developed and when substantial evidence on the record as a whole indicates that the claimant is
disabled and entitled to benefits.” Podedworny, 745 F.2d at 221-22 (citation and quotation
omitted); see A.B., 166 F. Supp.3d at 518. In assessing whether the record is fully developed to
support an award of benefits, courts take a more liberal approach when the claimant has already
faced long processing delays. See, e.g., Morales v. Apfel, 225 F.3d 310, 320 (3d Cir. 2000). An
award is “especially appropriate when “further administrative proceedings would simply prolong
[Plaintiff’s] waiting and delay his ultimate receipt of benefits.” Podedworny, 745 F.2d at 223;
see Schonewolf, 972 F. Supp. at 290.

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B.

Sequential Evaluation Process

The Social Security Act establishes a five-step sequential evaluation process for
determining whether a plaintiff is disabled within the meaning of the statute. 20 C.F.R §§
404.1520(a)(4), 416.920(a)(4). “The claimant bears the burden of proof at steps one through
four, and the Commissioner bears the burden of proof at step five.” Smith v. Comm’r of Soc.
Sec., 631 F.3d 632, 634 (3d Cir. 2010) (citing Poulos v. Comm’r of Soc. Sec., 474 F.3d 88, 92
(3d Cir. 2007)).
At step one, the ALJ determines whether the plaintiff is currently engaged in substantial
gainful activity. 20 C.F.R. §§ 404.1520(b), 416.920(b). If so, then the inquiry ends because the
plaintiff is not disabled.
At step two, the ALJ decides whether the plaintiff has a “severe impairment” or
combination of impairments that “significantly limits [the plaintiff’s] physical or mental ability
to do basic work activities[.]” 20 C.F.R. §§ 404.1520(c), 416.920(c). If the plaintiff does not
have a severe impairment or combination of impairments, then the inquiry ends because the
plaintiff is not disabled. Otherwise, the ALJ proceeds to step three.
At step three, the ALJ decides whether the plaintiff’s impairment or combination of
impairments “meets” or “medically equals” the severity of an impairment in the Listing of
Impairments (“Listing”) found at 20 C.F.R. § 404, Subpart P, Appendix 1. 20 C.F.R. §§
404.1520(d), 416.920(d). If so, then the plaintiff is presumed to be disabled if the impairment or
combination of impairments has lasted or is expected to last for a continuous period of at least 12
months. Id. at §§ 404.1509, 416.909. Otherwise, the ALJ proceeds to step four.
At step four, the ALJ must determine the plaintiff’s residual functional capacity (“RFC”)
and determine whether the plaintiff can perform past relevant work. 20 C.F.R. §§ 404.1520(e),
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(f), 416.920(e), (f). If the plaintiff can perform past relevant work, then the inquiry ends because
the plaintiff is not disabled. Otherwise, the ALJ proceeds to the final step.
At step five, the ALJ must decide whether the plaintiff, considering the plaintiff’s RFC,
age, education, and work experience, can perform other jobs that exist in significant numbers in
the national economy. 20 C.F.R. §§ 404.1520(g), 416.920(g). If the ALJ determines that the
plaintiff can do so, then the plaintiff is not disabled. Otherwise, the plaintiff is presumed to be
disabled if the impairment or combination of impairments has lasted or is expected to last for a
continuous period of at least twelve months.
III.

ALJ DECISION AND APPELLATE ISSUES
The Plaintiff was 45 years old on her alleged disability onset date. R. 30. At step one, the

ALJ found that Plaintiff had not engaged in substantial gainful activity since February 26, 2014,
her alleged disability onset date. R. 25.
At step two, the ALJ found that Plaintiff suffered from the following severe impairments:
rheumatoid arthritis, Sjogren’s syndrome, leukocytosis, posttraumatic stress disorder (“PTSD”),
adjustment disorder with depressed mood, and anxiety. Id. The ALJ also found that Plaintiff’s
diagnosed impairments of hypertension and hyperlipidemia were not severe. Id.
At step three, the ALJ found that Plaintiff did not suffer an impairment or combination
of impairments that met or medically equaled the severity of any Listing. R. 25–26.
At step four, the ALJ found that Plaintiff had the RFC to perform light work subject to
various additional limitations. R. 26–30. The ALJ also found that this RFC did not permit the
performance of Plaintiff’s past relevant work as tax preparer, retail sales/customer service,
receptionist, or counter attendant. R. 30.
At step five, the ALJ found that a significant number of jobs—i.e., approximately 2,500
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jobs as a mail clerk; approximately 236,000 jobs as an assembler; and approximately 51,000
jobs as a dispatcher/router—exist in the national economy and could be performed by an
individual with Plaintiff’s vocational profile and RFC. R. 31. The ALJ therefore concluded
that Plaintiff was not disabled within the meaning of the Social Security Act from February
26, 2014, Plaintiff’s alleged disability onset date, through the date of the decision. Id.
Plaintiff disagrees with the ALJ’s findings at steps three, four, and five and asks that the
decision of the Commissioner be reversed and remanded with directions for the granting of
benefits or, alternatively, for further proceedings. Plaintiff’s Brief, ECF No. 26; Plaintiff’s
Reply Brief, ECF No. 33. The Commissioner takes the position that his decision should be
affirmed in its entirety because the ALJ’s decision correctly applied the governing legal
standards, reflected consideration of the entire record, and was supported by sufficient
explanation and substantial evidence. Defendant’s Brief Pursuant to Local Civil Rule 9.1, ECF
No. 27.
IV.

DISCUSSION
Plaintiff argues that the ALJ erred in crafting her RFC. Plaintiff’s Brief, ECF No. 26, pp.

21–24; Plaintiff’s Reply Brief, ECF No. 33, pp. 1–8. Plaintiff specifically argues, inter alia, that
the ALJ improperly assigned “great weight” to the reviewing state agency medical consultants’
opinions, but then crafted an RFC that did not account for the physical limitations identified in
those opinions. Id. Plaintiff’s argument is well taken.
A claimant’s RFC is the most the claimant can do despite her limitations. 20 C.F.R. §§
404.1545(a)(1); 416.945(a)(1). At the administrative hearing stage, the administrative law judge
is charged with determining the claimant’s RFC. 20 C.F.R. §§ 404.1527(e), 404.1546(c);
416.927(e), 416.946(c); see also Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir.
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2011) (“The ALJ—not treating or examining physicians or State agency consultants—must
make the ultimate disability and RFC determinations.”) (citations omitted). When determining a
claimant’s RFC, the ALJ has a duty to consider all the evidence. Plummer, 186 F.3d at 429.
However, the ALJ need include only “credibly established” limitations. Rutherford v. Barnhart,
399 F.3d 546, 554 (3d Cir. 2005); see also Zirnsak v. Colvin, 777 F.3d 607, 615 (3d Cir. 2014)
(stating that the ALJ has discretion to choose whether to include “a limitation is supported by
medical evidence, but is opposed by other evidence in the record” but “[t]his discretion is not
unfettered—the ALJ cannot reject evidence of a limitation for an unsupported reason” and
stating that “the ALJ also has the discretion to include a limitation that is not supported by any
medical evidence if the ALJ finds the impairment otherwise credible”).
Here, the ALJ determined that Plaintiff had the RFC to perform a limited range of light
work, as follows:
After careful consideration of the entire record, I find that the claimant has the
residual functional capacity to perform light work as defined in 20 CFR
404.1567(b) and 416.967(b) except she can never climb ropes, ladders, or scaffolds;
never be exposed to unprotected heights or hazardous machinery; occasionally
climb stairs and ramps; never crawl; occasionally stoop and crouch; occasional
reaching overhead and frequent reaching in all other directions; frequent fingering
and handling; occasionally have exposure to extremes in environmental conditions
or extreme vibrations; occasional contact with supervisors, co-workers and the
public; able to do only simple and routine tasks.
R. 26 (emphasis added). In making this determination, the ALJ specifically considered the
opinions of the reviewing state agency medical consultants. R. 29, 93–114, 117–42. Lewis
Singer, M.D., conducted an initial review of Plaintiff’s medical record on July 30, 2015. R. 93–
114. Dr. Singer found that Plaintiff had fine and gross manipulative limitations in both hands
because of her rheumatoid arthritis involving her hands and wrists. R. 101–01, 112. He opined
that she should be limited to only occasional handling and fingering bilaterally. R. 101, 112.
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Pravin G. Sampat, M.D., reviewed Plaintiff’s medical record upon reconsideration for the state
agency on February 26, 2016. R. 117–42. Dr. Sampat agreed with Dr. Singer that Plaintiff had
fine and gross manipulative limitations in both hands because of her rheumatoid arthritis
involving her hands and wrists. R. 126, 139. He also agreed that Plaintiff should be limited to
only occasional handling and fingering bilaterally. Id.
The ALJ stated that he gave “great weight” to these reviewing state agency medical
consultants’ opinions “because they are based on a review of the medical evidence of record, and
they are consistent with the findings therein.” R. 29. However, as Plaintiff complains, the ALJ
actually crafted an RFC that did not account for this limitation but instead provided for
“frequent” fingering and handling. Plaintiff’s Brief, ECF No. 26, pp. 21, 24; Plaintiff’s Reply
Brief, ECF No. 33, pp. 1–4. Moreover, the ALJ failed to explain the inconsistency between this
RFC and the reviewing state agency medical consultants’ opinions regarding Plaintiff’s physical
limitations. Id. This inconsistency takes on even greater significance when one considers that the
vocational expert, upon whose testimony the ALJ relied, was asked to assume a claimant able to,
inter alia, engage in “[f]requent fingering and handling.” R. 30–31, 65–66. The ALJ’s failure to
include a limitation relating to only occasional handling and fingering and his failure to include
an explanation for this omission is therefore not harmless. See Matchett v. Comm’r, Soc. Sec.
Admin., No. CV 18-134 (RMB), 2019 WL 581801, at *3 (D.N.J. Feb. 13, 2019) (remanding
action where “[t]he ALJ’s decision does not explain why the residual functional capacity
determination omits any limitation on interactions with supervisors, even when the ALJ
expressly gave ‘significant weight’ to the evidence that ‘in a work setting [the claimant] would
not be able to interact appropriately with the public, co-workers, and supervisors’”) (citations
omitted); Capo v. Comm’r of Soc. Sec., No. CV 2:17-1280, 2018 WL 5982435, at *4 (W.D. Pa.
10

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Nov. 13, 2018) (remanding action where the “Plaintiff correctly argues that the ALJ’s RFC
finding [that limited the plaintiff, inter alia, to only occasional public interaction, but containing
no similar restrictions as to Plaintiff's interactions with supervisors and/or co-workers] appears
inconsistent with his acceptance of Dr. Marion’s moderate limitations, specifically, the moderate
limitation on interactions with supervisors and/or co-workers. Although the ALJ is entitled to
reject limitations that are unsupported by the record, he must provide the reasons for discounting
that evidence”). Accordingly, this Court cannot conclude that substantial evidence supports the
ALJ’s findings. See id.; Jones v. Berryhill, No. CV 17-119-E, 2018 WL 4627296, at *3 (W.D.
Pa. Sept. 26, 2018) (remanding action where, inter alia, although the ALJ gave some weight to
the findings and opinion of a consultative psychologist, the ALJ did not include in Plaintiff’s
RFC any accommodations regarding certain limitations and, “[a]lternatively, the ALJ does not
explain why he found no need to include any such limitations in social functioning in Plaintiff’s
RFC”); Sanford v. Comm’r of Soc. Sec., No. CIV. 13-0366 NLH, 2014 WL 1294710, at *2
(D.N.J. Mar. 28, 2014) (“The Third Circuit has held that access to the Commissioner’s reasoning
is [ ] essential to a meaningful court review.”) (citing Gober v. Matthews, 574 F.2d 772, 776 (3d
Cir. 1978)).
This Court therefore concludes that the decision of the Commissioner must be reversed,
and the matter must be remanded to the Commissioner for further consideration of the opinions
of the reviewing state agency medical consultants and the RFC determination. Remand is
appropriate, moreover, even if further examination of these issues again persuades the ALJ that
Plaintiff is not entitled to benefits. Cf. Zuschlag v. Comm’r of Soc. Sec. Admin., No. 18-CV1949, 2020 WL 5525578, at *8 (D.N.J. Sept. 15, 2020) (“On remand, the ALJ may reach the
same conclusion, but it must be based on a proper foundation.”); Jiminez v. Comm’r of Soc. Sec.,
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No. CV 19-12662, 2020 WL 5105232, at *4 (D.N.J. Aug. 28, 2020) (“Once more, the ALJ did
not provide an adequate explanation that would enable meaningful review, and the Court once
more cannot determine what role lay speculation played in the ALJ’s rejection of this detailed
functional assessment from Dr. Marks.”); Cassidy v. Colvin, No. 2:13-1203, 2014 WL 2041734,
at *10 n.3 (W.D. Pa. May 16, 2014) (“Nevertheless, that the ALJ may have misinterpreted or
misunderstood Dr. Kaplan’s findings with regard to Plaintiff's postural activities does not
absolve her of her error. Rather, it highlights the need for an ALJ to fully explain her findings.
Otherwise, the district court is left to engage in this sort of speculation about how an ALJ arrived
at her decision.”). 3
V.

CONCLUSION
For these reasons, the Court REVERSES the Commissioner’s decision and REMANDS

the matter for further proceedings consistent with this Opinion and Order.
The Court will issue a separate Order issuing final judgment pursuant to Sentence 4 of 42
U.S.C. § 405(g).

IT IS SO ORDERED.

Date: July 19, 2021

s/Norah McCann King
NORAH McCANN KING
UNITED STATES MAGISTRATE JUDGE

Plaintiff asserts a number of other errors in the Commissioner’s final decision. Because the
Court concludes that the matter must be remanded for further consideration of the reviewing
state agency medical consultants’ opinions and RFC determination, the Court does not consider
those claims.
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